AN ACT
relating to programs for public employees; increasing the amount to be paid by
this state for group insurance for certain public employees, public officers
and retired public employees; requiring the board of the public employees
benefits program to issue a request for information or proposals concerning
privatization of the program; and providing other matters properly relating
thereto.

Section 1. For
the purposes of NRS 287.044 and 287.0445 and subsection 1 of NRS 287.046, this
states share of the cost of premiums or contributions for group insurance for
each public officer or employee who elects to participate in the public
employees benefits program is:

Sec. 2. For the
purposes of subsection 2 of NRS 287.046, the base amount for this states share
of the cost of premiums or contributions for group insurance for each person
who is retired from the service of this state and continues to participate in
the public employees benefits program is:

Sec. 3. The
board of the public employees benefits program shall ensure that:

1. No
state employee who is a member of the program is required to pay, for the
fiscal year 2002-2003, any part of the cost of the premiums or contributions
for the program which are attributable to the health benefits coverage of the
employee by the program. The provisions of this subsection do not prohibit requiring
a state employee to pay the cost of the premiums or contributions attributable
to the coverage of the state employees dependents by the program.

2. Any money resulting from the amendatory
provisions of section 1 of this act that exceeds the amount necessary to carry
out the provisions of subsection 1 is applied to reserves or used to maintain
current health benefits.

Sec. 4. The board of the public
employees benefits program shall issue a request for information or a request
for proposals to determine whether privatization of the public employees
benefits program is economically feasible. The board of the public employees
benefits program shall require that any information or proposals returned in
response to a request issued pursuant to this section are returned to the board
in sufficient time to allow the board to use such information or proposals when
making any decisions regarding any plan for benefits that will begin on or
after July 1, 2003.

Sec. 5. This act becomes effective
on October 1, 2002.

________

CHAPTER 2, SB 1

Senate Bill No.
1Senators Raggio and Titus

CHAPTER 2

AN ACT making an appropriation to the legislative fund
for the costs of the 18th Special Session; and providing other matters properly
relating thereto.

[Approved: August 6, 2002]

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. There is hereby
appropriated from the state general fund to the legislative fund created by NRS
218.085 the sum of $160,000 for the costs of the 18th Special Session.

AN ACT
relating to malpractice; limiting the liability of certain medical providers
for negligent acts under certain circumstances; establishing a limitation on
the amount of noneconomic damages that may be awarded in an action for medical
malpractice or dental malpractice; providing for several liability of a defendant
for noneconomic damages in an action for medical malpractice; making various
changes concerning the payment of future economic damages in actions for
medical malpractice; providing for the mandatory dismissal of an action for
medical malpractice or dental malpractice under certain circumstances;
repealing the provisions pertaining to the use of screening panels for an
action for medical malpractice or dental malpractice; revising the statute of
limitations for filing an action for medical malpractice or dental malpractice;
making various other changes concerning actions for medical malpractice or
dental malpractice; requiring certain district judges to receive training
concerning the complex issues involved in medical malpractice litigation;
requiring courts to impose certain sanctions on attorneys in certain
circumstances; making various changes relating to the reporting of claims of
malpractice or negligence; requiring the commissioner of insurance to report to
the legislative commission and the legislature regarding certain premiums for
insurance and certain jury verdicts and settlements; and providing other
matters properly relating thereto.

[Approved: August 7, 2002]

Whereas, The State of Nevada is
experiencing extreme difficulties attracting and maintaining a sufficient
network of physicians to meet the needs of the residents of this state; and

Whereas, The Nevada Legislature
has determined that the shortage of physicians and the inability to attract new
physicians to this state pose a serious threat to the health, welfare and
safety of the residents of the State of Nevada; and

Whereas, It is recognized that
patients who have been injured by medical malpractice must be afforded
appropriate access to legal remedies for their injuries and that judicial
discretion to render decisions in malpractice actions involving exceptional
circumstances must be preserved; now, therefore,

Section 1. Chapter 41 of NRS is
hereby amended by adding thereto a new section to read as follows:

1. Except
as otherwise provided in subsection 2 and NRS 41.505:

(a) A
hospital which has been designated as a center for the treatment of trauma by
the administrator of the health division of the department of human resources
pursuant to NRS 450B.237 and which is a nonprofit organization;

(b) A hospital other than a
hospital described in paragraph (a);

(c) An
employee of a hospital described in paragraph (a) or (b) who renders care or
assistance to patients;

(d) A
physician or dentist licensed under the provisions of chapter 630, 631 or 633
of NRS who renders care or assistance in a hospital described in paragraph (a)
or (b), whether or not the care or assistance was rendered gratuitously or for
a fee; and

(e) A
physician or dentist licensed under the provisions of chapter 630, 631 or 633
of NRS:

(1) Whose
liability is not otherwise limited pursuant to NRS 41.032 to 41.0337,
inclusive; and

(2) Who
renders care or assistance in a hospital of a governmental entity that has been
designated as a center for the treatment of trauma by the administrator of the
health division of the department of human resources pursuant to NRS 450B.237,
whether or not the care or assistance was rendered gratuitously or for a fee,

that in good faith
renders care or assistance necessitated by a traumatic injury demanding
immediate medical attention, for which the patient enters the hospital through
its emergency room or trauma center, may not be held liable for more than
$50,000 in civil damages, exclusive of interest computed from the date of
judgment, to or for the benefit of any claimant arising out of any act or
omission in rendering that care or assistance if the care or assistance is
rendered in good faith and in a manner not amounting to gross negligence or
reckless, willful or wanton conduct.

2. The
limitation on liability provided pursuant to this section does not apply to any
act or omission in rendering care or assistance:

(a) Which
occurs after the patient is stabilized and is capable of receiving medical
treatment as a nonemergency patient, unless surgery is required as a result of
the emergency within a reasonable time after the patient is stabilized, in
which case the limitation on liability provided by subsection 1 applies to any
act or omission in rendering care or assistance which occurs before the
stabilization of the patient following the surgery; or

(b) Unrelated
to the original traumatic injury.

3. If:

(a) A
physician or dentist provides follow-up care to a patient to whom he rendered
care or assistance pursuant to subsection 1;

(b) A
medical condition arises during the course of the follow-up care that is
directly related to the original traumatic injury for which care or assistance
was rendered pursuant to subsection 1; and

(c) The
patient files an action for malpractice based on the medical condition that
arises during the course of the follow-up care,

there is a rebuttable
presumption that the medical condition was the result of the original traumatic
injury and that the limitation on liability provided

by subsection 1
applies with respect to the medical condition that arises during the course of
the follow-up care.

4. For the purposes of
this section:

(a) Reckless,
willful or wanton conduct, as it applies to a person to whom subsection 1
applies, shall be deemed to be that conduct which the person knew or should
have known at the time he rendered the care or assistance would be likely to
result in injury so as to affect the life or health of another person, taking
into consideration to the extent applicable:

(1) The
extent or serious nature of the prevailing circumstances;

(2) The
lack of time or ability to obtain appropriate consultation;

(3) The
lack of a prior medical relationship with the patient;

(4) The
inability to obtain an appropriate medical history of the patient; and

(5) The
time constraints imposed by coexisting emergencies.

(b) Traumatic
injury means any acute injury which, according to standardized criteria for
triage in the field, involves a significant risk of death or the precipitation
of complications or disabilities.

Sec. 1.5. NRS 41.505 is hereby
amended to read as follows:

41.505 1. Any physician or
registered nurse who in good faith gives instruction or provides supervision to
an emergency medical attendant or registered nurse, at the scene of an
emergency or while transporting an ill or injured person from the scene of an
emergency, is not liable for any civil damages as a result of any act or
omission, not amounting to gross negligence, in giving that instruction or
providing that supervision. An emergency medical attendant, registered nurse or
licensed practical nurse who obeys an instruction given by a physician,
registered nurse or licensed practical nurse and thereby renders emergency
care, at the scene of an emergency or while transporting an ill or injured
person from the scene of an emergency, is not liable for any civil damages as a
result of any act or omission, not amounting to gross negligence, in rendering
that emergency care.

2. Except as otherwise provided in
subsection 3, any person licensed under the provisions of chapter 630, 632 or
633 of NRS and any person who holds an equivalent license issued by another
state, who renders emergency care or assistance in an emergency, gratuitously
and in good faith, is not liable for any civil damages as a result of any act
or omission, not amounting to gross negligence, by him in rendering the
emergency care or assistance or as a result of any failure to act, not
amounting to gross negligence, to provide or arrange for further medical
treatment for the injured or ill person. This section does not excuse a
physician or nurse from liability for damages resulting from his acts or
omissions which occur in a licensed medical facility relative to any person
with whom there is a preexisting relationship as a patient.

3. Any person licensed under the provisions
of chapter 630, 632 or 633 of NRS and any person who holds an equivalent
license issued by another state who renders emergency obstetrical care or
assistance to a pregnant woman during labor or the delivery of the child is not
liable for any civil damages as a result of any act or omission by him in
rendering that care or assistance if:

(a) The care or assistance is rendered in good
faith and in a manner not amounting to gross negligence or reckless, willful or
wanton conduct;

(b) The person has not previously provided prenatal
or obstetrical care to the woman; and

(c) The damages are reasonably related to or
primarily caused by a lack of prenatal care received by the woman.

A licensed medical facility in which such care or assistance
is rendered is not liable for any civil damages as a result of any act or
omission by the person in rendering that care or assistance if that person is
not liable for any civil damages pursuant to this subsection and the actions of
the medical facility relating to the rendering of that care or assistance do
not amount to gross negligence or reckless, willful or wanton conduct.

4. Any person licensed under the provisions
of chapter 630, 632 or 633 of NRS and any person who holds an equivalent
license issued by another state who:

(a) Is retired or otherwise does not practice on a
full-time basis; and

(b) Gratuitously and in good faith, renders medical
care within the scope of his license to an indigent person,

is not liable for any civil damages as a result of any act or
omission by him, not amounting to gross negligence or reckless, willful or
wanton conduct, in rendering that care.

5. Any person licensed to practice medicine under the
provisions of chapter 630 or 633 of NRS or licensed to practice dentistry under
the provisions of chapter 631 of NRS who renders care or assistance to a
patient at a health care facility of a governmental entity or a nonprofit
organization is not liable for any civil damages as a result of any act or
omission by him in rendering that care or assistance if the care or assistance
is rendered gratuitously, in good faith and in a manner not amounting to gross
negligence or reckless, willful or wanton conduct.

Sec. 5. 1. Except as otherwise
provided in subsection 2 and except as further limited in subsection 3, in an
action for damages for medical malpractice or dental malpractice, the noneconomic
damages awarded to each plaintiff from each defendant must not exceed $350,000.

2. In an action for
damages for medical malpractice or dental malpractice, the limitation on
noneconomic damages set forth in subsection 1 does not apply in the following
circumstances and types of cases:

(a) A case in which the
conduct of the defendant is determined to constitute gross malpractice; or

(b) A case in which, following
return of a verdict by the jury or a finding of damages in a bench trial, the
court determines, by clear and convincing evidence admitted at trial, that an
award in excess of $350,000 for noneconomic damages is justified because of
exceptional circumstances.

3. Except as otherwise
provided in subsection 4, in an action for damages for medical malpractice or
dental malpractice, in the circumstances and types of cases described in
subsections 1 and 2, the noneconomic damages awarded to each plaintiff from
each defendant must not exceed the amount of money remaining under the
professional liability insurance policy limit covering the defendant after
subtracting the economic damages awarded to that plaintiff. Irrespective of the
number of plaintiffs in the action, in no event may any single defendant be
liable to the plaintiffs in the aggregate in excess of the professional
liability insurance policy limit covering that defendant.

4. The
limitation set forth in subsection 3 does not apply in an action for damages
for medical malpractice or dental malpractice unless the defendant was covered
by professional liability insurance at the time of the occurrence of the
alleged malpractice and on the date on which the insurer receives notice of the
claim, in an amount of:

(a) Not
less than $1,000,000 per occurrence; and

(b) Not
less than $3,000,000 in the aggregate.

5. This section is not
intended to limit the responsibility of any defendant for the total economic
damages awarded.

6. For
the purposes of this section, gross malpractice means failure to exercise the
required degree of care, skill or knowledge that amounts to:

(a) A
conscious indifference to the consequences which may result from the gross
malpractice; and

(b) A disregard for and
indifference to the safety and welfare of the patient.

Sec. 6. 1. In an action for damages for medical
malpractice, each defendant is liable for noneconomic damages severally only,
and not jointly, to the plaintiff only for that portion of the judgment which
represents the percentage of negligence attributable to the defendant.

2. As
used in this section, medical malpractice means the failure of a physician,
hospital, employee of a hospital, certified nurse midwife or certified
registered nurse anesthetist in rendering services to use the reasonable care,
skill or knowledge ordinarily used under similar circumstances.

Sec. 7. 1. Upon the motion of any party or upon its own
motion, unless good cause is shown for the delay, the court shall, after due
notice to the parties, dismiss an action involving medical malpractice or
dental malpractice if the action is not brought to trial within:

(a) Three
years after the date on which the action is filed, if the action is filed on or
after October 1, 2002, but before October 1, 2005.

(b) Two
years after the date on which the action is filed, if the action is filed on or
after October 1, 2005.

2. Dismissal of an
action pursuant to subsection 1 is a bar to the filing of another action upon
the same claim for relief against the same defendants.

3. Each
district court shall adopt court rules to expedite the resolution of an action
involving medical malpractice or dental malpractice.

Sec. 8. If an action for medical malpractice or dental malpractice
is filed in the district court, the district court shall dismiss the action,
without prejudice, if the action is filed without an affidavit, supporting the
allegations contained in the action, submitted by a medical expert who
practices or has practiced in an area that is substantially similar to the type
of practice engaged in at the time of the alleged malpractice.

Sec. 9. 1. In an action for medical malpractice or
dental malpractice, all the parties to the action, the insurers of the
respective parties and the attorneys of the respective parties shall attend and
participate in a settlement conference before a district judge, other than the
judge assigned to the action, to ascertain whether the action may be settled by
the parties before trial.

2. The
judge before whom the settlement conference is held:

(a) May,
for good cause shown, waive the attendance of any party.

(b) Shall
decide what information the parties may submit at the settlement conference.

3. The
judge shall notify the parties of the time and place of the settlement
conference.

4. The
failure of any party, his insurer or his attorney to participate in good faith
in the settlement conference is grounds for sanctions against the party or his
attorney, or both.

Sec. 10. NRS 41A.003 is hereby
amended to read as follows:

41A.003 As used in this chapter, unless the
context otherwise requires, the words and terms defined in NRS 41A.004 [to
41A.013, inclusive,], 41A.009 and 41A.013 and sections 3 and 4 of this act have
the meanings ascribed to them in those sections.

Sec. 11. NRS 41A.097 is hereby
amended to read as follows:

41A.097 1. Except as otherwise
provided in subsection [2,] 3, an action for injury or death against a
provider of health care may not be commenced more than 4 years after the date
of injury or 2 years after the plaintiff discovers or through the use of
reasonable diligence should have discovered the injury, whichever occurs first,
for:

(a) Injury to or the wrongful death of a person[,]occurring before October 1, 2002, based
upon alleged professional negligence of the provider of health care;

(b) Injury to or the wrongful death of a person occurring before October 1, 2002, from
professional services rendered without consent; or

(c) Injury to or the wrongful death of a person occurring before October 1, 2002, from
error or omission in practice by the provider of health care.

2. Except
as otherwise provided in subsection 3, an action for injury or death against a
provider of health care may not be commenced more than 3 years after the date
of injury or 2 years after the plaintiff discovers or through the use of
reasonable diligence should have discovered the injury, whichever occurs first,
for:

(a) Injury
to or the wrongful death of a person occurring on or after October 1, 2002,
based upon alleged professional negligence of the provider of health care;

(b) Injury
to or the wrongful death of a person occurring on or after October 1, 2002,
from professional services rendered without consent; or

(c) Injury
to or the wrongful death of a person occurring on or after October 1, 2002,
from error or omission in practice by the provider of health care.

3. This
time limitation is tolled[:

(a) For]for any period
during which the provider of health care has concealed any act, error or
omission upon which the action is based and which is known or through the use
of reasonable diligence should have been known to him.

[(b) In
any action governed by the provisions of NRS 41A.003 to 41A.069, inclusive,
from the date a claimant files a complaint for review by a screening panel
until 30 days after the date the panel notifies the claimant, in writing, of
its findings. The provisions of this paragraph apply to an action against the
provider of health care and to an action against any person, government or political
subdivision of a government who is alleged by the claimant to be liable
vicariously for the medical or dental malpractice of the provider of health
care, if the provider, person, government or political subdivision has received
notice of the filing of a complaint for review by a screening panel within the
limitation of time provided in subsection 1.

3.]4. For the
purposes of this section, the parent, guardian or legal custodian of any minor
child is responsible for exercising reasonable judgment in determining whether
to prosecute any cause of action limited by subsection 1[.]or 2. If the parent, guardian
or custodian fails to commence an action on behalf of that child within the
prescribed period of limitations, the child may not bring an action based on
the same alleged injury against any provider of health care upon the removal of
his disability, except that in the case of:

(a) Brain damage or birth defect, the period of
limitation is extended until the child attains 10 years of age.

(b) Sterility, the period of limitation is extended
until 2 years after the child discovers the injury.

[4.]5. As used in this section, provider
of health care means a physician licensed under chapter 630 or 633 of NRS,
dentist, registered nurse, dispensing optician, optometrist, registered
physical therapist, podiatric physician, licensed psychologist, chiropractor,
doctor of Oriental medicine, medical laboratory director or technician, or a
licensed hospital as the employer of any such person.

Sec. 12. NRS 41A.100 is hereby
amended to read as follows:

41A.100 1. Liability for
personal injury or death is not imposed upon any provider of medical care based
on alleged negligence in the performance of that care unless evidence
consisting of expert medical testimony, material from recognized medical texts
or treatises or the regulations of the licensed medical facility wherein the
alleged negligence occurred is presented to demonstrate the alleged deviation
from the accepted standard of care in the specific circumstances of the case
and to prove causation of the alleged personal injury or death, except that
such evidence is not required and a rebuttable presumption that the personal
injury or death was caused by negligence arises where evidence is presented
that the personal injury or death occurred in any one or more of the following
circumstances:

(a) A foreign substance other than medication or a
prosthetic device was unintentionally left within the body of a patient
following surgery;

(b) An explosion or fire originating in a substance
used in treatment occurred in the course of treatment;

(c) An unintended burn caused by heat, radiation or
chemicals was suffered in the course of medical care;

(d) An injury was suffered during the course of
treatment to a part of the body not directly involved in the treatment or
proximate thereto; or

(e) A surgical procedure was performed on the wrong
patient or the wrong organ, limb or part of a patients body.

2. Expert medical testimony provided pursuant to subsection 1
may only be given by a provider of medical care who practices or has practiced in
an area that is substantially similar to the type of practice engaged in at the
time of the alleged negligence.

3. As
used in this section, provider of medical care means a physician, dentist,
registered nurse or a licensed hospital as the employer of any such person.

Sec. 13. NRS 42.020 is hereby
amended to read as follows:

42.020 1. Except as otherwise
provided in subsection 2, in any action for damages for medical malpractice,
the amount of damages, if any, awarded in the action must be reduced by the amount
of any prior payment made by or on behalf of the provider of health care
against whom the action is brought to the injured person or to the claimant to
meet reasonable expenses of medical care, other essential goods or services or
reasonable living expenses.

2. In any action described in subsection 1
in which liability for medical malpractice is established or admitted, the
court shall, before the entry of judgment, hold a separate hearing to determine
if any expenses incurred by the claimant for medical care, loss of income or
other financial loss have been paid or reimbursed as a benefit from a
collateral source. If the court determines that a claimant has received such a
benefit, the court shall reduce the amount of damages, if any, awarded in the
action by the amount of the benefit. The amount so reduced must not include any
amount for which there is a right of subrogation to the rights of the claimant
if the right of subrogation is exercised by serving a notice of lien on the
claimant before the settlement of or the entry of judgment in the action.
Notice of the action must be provided by the claimant to any statutory holder
of a lien.

3. If future economic damages are awarded in
an action for medical malpractice, the [award must be paid, at the
election of the claimant:] court may, at the request of the claimant, order the award
to be paid:

(a) In a lump sum which has been reduced to its
present value as determined by the trier of fact and approved by the court; or

(b) Subject to the provisions of [subsection
5,]subsections
5 and 6 and the discretion of the court, in periodic payments either by
an annuity purchased to provide periodic payments[.] or by other means if the defendant
posts an adequate bond or other security to ensure full payment by periodic
payments of the damages awarded by the judgment.

As used in this subsection, future economic damages
includes damages for future medical treatment, care or custody, and loss of
future earnings.

4. If the claimant [elects to receive]receives periodic
payments pursuant to paragraph (b) of subsection 3, the award must not be
reduced to its present value. The amount of the periodic payments must be equal
to the total amount of all future damages awarded by the trier of fact and
approved by the court. The period for which the periodic payments must be made
must be determined by the trier of fact and approved by the court. Before the
entry of

judgment, each party shall submit to the court a plan
specifying the recipient of the payments, the amount of the payments and a
schedule of periodic payments for the award. Upon receipt and review of the plans,
the court shall specify in its judgment rendered in the action the recipient of
the payments, the amount of the payments and a schedule of payments for the
award.

5. If an annuity is purchased pursuant to
paragraph (b) of subsection 3, the claimant shall select the provider of the
annuity. Upon purchase of the annuity, the claimant shall:

(a) Execute a satisfaction of judgment or a
stipulation for dismissal of the claim with prejudice; and

(b) Release forever the defendant and his insurer,
if any, from any obligation to make periodic payments pursuant to the award.

6. If the defendant posts a bond or other security pursuant to
paragraph (b) of subsection 3, upon termination of the payment of periodic
payments of damages, the court shall order the return of the bond or other
security, or as much as remains, to the defendant.

7. As
used in this section:

(a) Benefit from a collateral source means any
money, service or other benefit which is paid or provided or is reasonably
likely to be paid or provided to a claimant for personal injury or wrongful
death pursuant to:

(1) A state or federal act which provides
benefits for sickness, disability, accidents, loss of income or workers
compensation;

(2) A policy of insurance which provides
health benefits or coverage for loss of income;

(3) A contract of any group, organization,
partnership or corporation which provides, pays or reimburses the cost of
medical, hospital or dental benefits or benefits for loss of income; or

(4) Any other publicly or privately funded
program which provides such benefits.

(b) Medical malpractice has the meaning ascribed
to it in NRS 41A.009.

Sec. 14. NRS
1.360 is hereby amended to read as follows:

1.360 Under the direction of the supreme
court, the court administrator shall:

1. Examine the administrative procedures
employed in the offices of the judges, clerks, court reporters and employees of
all courts of this state and make recommendations, through the chief justice,
for the improvement of those procedures;

2. Examine the condition of the dockets of
the courts and determine the need for assistance by any court;

3. Make recommendations to and carry out the
directions of the chief justice relating to the assignment of district judges
where district courts are in need of assistance;

4. Develop a uniform system for collecting
and compiling statistics and other data regarding the operation of the state
court system and transmit that information to the supreme court so that proper
action may be taken in respect thereto;

5. Prepare and submit a budget of state
appropriations necessary for the maintenance and operation of the state court
system and make recommendations in respect thereto;

6. Develop procedures for accounting,
internal auditing, procurement and disbursement for the state court system;

7. Collect statistical and other data and
make reports relating to the expenditure of all public money for the
maintenance and operation of the state court system and the offices connected
therewith;

8. Compile statistics from the information
required to be maintained by the clerks of the district courts pursuant to NRS
3.275 and make reports as to the cases filed in the district courts;

9. Formulate and submit to the supreme court
recommendations of policies or proposed legislation for the improvement of the
state court system;

10. On or before January 1 of each year,
submit to the director of the legislative counsel bureau a written report
compiling the information submitted to the court administrator pursuant to NRS
3.243, 4.175 and 5.045 during the immediately preceding fiscal year; [and]

11. On or before February 15 of each odd-numbered year, submit
to the governor and to the director of the legislative counsel bureau for
transmittal to the next regular session of the legislature a written report
compiling the information submitted by clerks of courts to the court
administrator pursuant to NRS 630.307 and section 64 of this act which includes
only aggregate information for statistical purposes and excludes any identifying
information related to a particular person; and

12. Attend
to such other matters as may be assigned by the supreme court or prescribed by
law.

Sec. 15. Chapter 3 of NRS is hereby
amended by adding thereto a new section to read as follows:

The supreme court
shall provide by court rule for mandatory appropriate training concerning the
complex issues of medical malpractice litigation for each district judge to
whom actions involving medical malpractice are assigned.

Sec. 16. NRS 7.085 is hereby amended
to read as follows:

7.085 If a court finds that an attorney has:

1. Filed, maintained or defended a civil
action or proceeding in any court in this state and such action or defense is
not well-grounded in fact or is not warranted by existing law or by an argument
for changing the existing law that is made in good faith; or

2. Unreasonably and vexatiously extended a
civil action or proceeding before any court in this state,

the court [may]shall require the attorney personally to pay
the additional costs, expenses and attorneys fees reasonably incurred because
of such conduct.

Sec. 17. NRS 49.245 is hereby
amended to read as follows:

49.245 There is no privilege under NRS
49.225 or 49.235:

1. For communications relevant to an issue
in proceedings to hospitalize the patient for mental illness, if the doctor in
the course of diagnosis or treatment has determined that the patient is in need
of hospitalization.

2. As to communications made in the course
of a court-ordered examination of the condition of a patient with respect to
the particular purpose of the examination unless the court orders otherwise.

3. As to written medical or hospital records
relevant to an issue of the condition of the patient in any proceeding in which
the condition is an element of a claim or defense.

5. As to any information communicated to a
physician in an effort unlawfully to procure a dangerous drug or controlled
substance, or unlawfully to procure the administration of any such drug or
substance.

6. As to any written medical or hospital
records which are furnished in accordance with the provisions of NRS 629.061.

7. As to records that are required by
chapter 453 of NRS to be maintained.

8. [In a review before a
screening panel pursuant to NRS 41A.003 to 41A.069, inclusive.

9.] If
the services of the physician are sought or obtained to enable or aid a person
to commit or plan to commit fraud or any other unlawful act in violation of any
provision of chapter 616A, 616B, 616C, 616D or 617 of NRS which the person
knows or reasonably should know is fraudulent or otherwise unlawful.

Sec. 18. Chapter 439 of NRS is
hereby amended by adding thereto the provisions set forth as sections 19 to 39,
inclusive, of this act.

Sec. 19. As used in sections 19 to 39, inclusive, of this act, unless
the context otherwise requires, the words and terms defined in sections 20 to
25, inclusive, of this act have the meanings ascribed to them in those
sections.

Sec. 20. Medical facility means:

1. A hospital, as that
term is defined in NRS 449.012 and 449.0151;

2. An obstetric center,
as that term is defined in NRS 449.0151 and 449.0155;

3. A surgical center
for ambulatory patients, as that term is defined in NRS 449.0151 and 449.019;
and

4. An independent
center for emergency medical care, as that term is defined NRS 449.013 and
449.0151.

Sec. 21. Patient means a person who:

1. Is
admitted to a medical facility for the purpose of receiving treatment;

2. Resides
in a medical facility; or

3. Receives
treatment from a provider of health care.

Sec. 22. Patient safety officer means a person who is designated as
such by a medical facility pursuant to section 35 of this act.

Sec. 23. Provider of health care means a person who is licensed,
certified or otherwise authorized by the law of this state to administer health
care in the ordinary course of the business or practice of a profession.

Sec. 24. Repository means the repository for health care quality
assurance created by section 31 of this act.

Sec. 25. Sentinel event means an unexpected occurrence involving
death or serious physical or psychological injury or the risk thereof,
including, without limitation, any process variation for which a recurrence
would carry a significant chance of a serious adverse outcome. The term
includes loss of limb or function.

Secs. 26 and 27. (Deleted by amendment.)

Sec. 28. 1. Except as otherwise provided in subsection
2:

(a) A
person who is employed by a medical facility shall, within 24 hours after
becoming aware of a sentinel event that occurred at the medical facility,
notify the patient safety officer of the facility of the sentinel event; and

(b) The
patient safety officer shall, within 13 days after receiving notification
pursuant to paragraph (a), report the date, the time and a brief description of
the sentinel event to:

(1) The
health division; and

(2) The
representative designated pursuant to section 32 of this act, if that person is
different from the patient safety officer.

2. If
the patient safety officer of a medical facility personally discovers or
becomes aware, in the absence of notification by another employee, of a
sentinel event that occurred at the medical facility, the patient safety
officer shall, within 14 days after discovering or becoming aware of the
sentinel event, report the date, time and brief description of the sentinel
event to:

(a) The
health division; and

(b) The
representative designated pursuant to section 32 of this act, if that person is
different from the patient safety officer.

3. The
administrator shall prescribe the manner in which reports of sentinel events
must be made pursuant to this section.

Sec. 29. 1. The health division shall, to the extent of
legislative appropriation and authorization:

(a) Collect
and maintain reports received pursuant to section 28 of this act; and

(b) Ensure
that such reports, and any additional documents created from such reports, are
protected adequately from fire, theft, loss, destruction and other hazards and
from unauthorized access.

2. Reports
received pursuant to section 28 of this act are confidential, not subject to
subpoena or discovery and not subject to inspection by the general public.

Sec. 30. 1. The health division shall, to the extent of
legislative appropriation and authorization, contract with a quality
improvement organization, as defined in 42 C.F.R. § 400.200, to analyze and
report trends regarding sentinel events.

2. When
the health division receives notice from a medical facility that the medical
facility has taken corrective action to remedy the causes or contributing
factors, or both, of a sentinel event, the health division shall:

(a) Make a
record of the information;

(b) Ensure
that the information is aggregated so as not to reveal the identity of a
specific person or medical facility; and

(c) Transmit
the information to a quality improvement organization.

3. A
quality improvement organization to whom information is transmitted pursuant to
subsection 2 shall, at least quarterly, report its findings regarding the
analysis of aggregated trends of sentinel events to the repository for health
care quality assurance.

Sec. 31. 1. The repository for health care quality
assurance is hereby created within the health division.

2. The
repository shall, to the extent of legislative appropriation and authorization,
function as a clearinghouse of information relating to aggregated trends of
sentinel events.

Sec. 32. 1. Each medical facility that is located within
this state shall designate a representative for the notification of patients
who have been involved in sentinel events at that medical facility.

2. A
representative designated pursuant to subsection 1 shall, not later than 7 days
after discovering or becoming aware of a sentinel event that

occurred at the
medical facility, provide notice of that fact to each patient who was involved
in that sentinel event.

3. The
provision of notice to a patient pursuant to subsection 2 must not, in any
action or proceeding, be considered an acknowledgment or admission of
liability.

4. A
representative designated pursuant to subsection 1 may or may not be the same
person who serves as the facilitys patient safety officer.

Sec. 33. Any report, document and any other information compiled or
disseminated pursuant to the provisions of sections 19 to 39, inclusive, of
this act is not admissible in evidence in any administrative or legal
proceeding conducted in this state.

Sec. 34. 1. Each medical facility that is located within
this state shall develop, in consultation with the providers of health care who
provide treatment to patients at the medical facility, an internal patient
safety plan to improve the health and safety of patients who are treated at
that medical facility.

2. A
medical facility shall submit its patient safety plan to the governing board of
the medical facility for approval in accordance with the requirements of this
section.

3. After
a medical facilitys patient safety plan is approved, the medical facility
shall notify all providers of health care who provide treatment to patients at
the medical facility of the existence of the plan and of the requirements of
the plan. A medical facility shall require compliance with its patient safety
plan.

Sec. 35. 1. A medical facility shall designate an
officer or employee of the facility to serve as the patient safety officer of
the medical facility.

2. The
person who is designated as the patient safety officer of a medical facility
shall:

(a) Serve
on the patient safety committee.

(b) Supervise
the reporting of all sentinel events alleged to have occurred at the medical
facility, including, without limitation, performing the duties required
pursuant to section 28 of this act.

(c) Take
such action as he determines to be necessary to ensure the safety of patients
as a result of an investigation of any sentinel event alleged to have occurred
at the medical facility.

(d) Report
to the patient safety committee regarding any action taken in accordance with
paragraph (c).

(a) A patient
safety committee established pursuant to subsection 1 must be composed of:

(1) The
patient safety officer of the medical facility.

(2) At least three
providers of health care who treat patients at the medical facility, including,
without limitation, at least one member of the medical, nursing and
pharmaceutical staff of the medical facility.

(3) One
member of the executive or governing body of the medical facility.

(b) A
patient safety committee shall meet at least once each month.

3. The
administrator shall adopt regulations prescribing the composition and frequency
of meetings of patient safety committees at medical facilities having fewer
than 25 employees and contractors.

(a) Receive
reports from the patient safety officer pursuant to section 35 of this act.

(b) Evaluate
actions of the patient safety officer in connection with all reports of
sentinel events alleged to have occurred at the medical facility.

(c) Review
and evaluate the quality of measures carried out by the medical facility to
improve the safety of patients who receive treatment at the medical facility.

(d) Make
recommendations to the executive or governing body of the medical facility to
reduce the number and severity of sentinel events that occur at the medical
facility.

(e) At
least once each calendar quarter, report to the executive or governing body of
the medical facility regarding:

(1) The
number of sentinel events that occurred at the medical facility during the
preceding calendar quarter; and

(2) Any
recommendations to reduce the number and severity of sentinel events that occur
at the medical facility.

5. The
proceedings and records of a patient safety committee are subject to the same
privilege and protection from discovery as the proceedings and records
described in NRS 49.265.

Sec. 37. No person is subject to any criminal penalty or civil
liability for libel, slander or any similar cause of action in tort if he,
without malice:

1. Reports
a sentinel event to a governmental entity with jurisdiction or another
appropriate authority;

2. Notifies
a governmental entity with jurisdiction or another appropriate authority of a
sentinel event;

3. Transmits
information regarding a sentinel event to a governmental entity with
jurisdiction or another appropriate authority;

4. Compiles,
prepares or disseminates information regarding a sentinel event to a
governmental entity with jurisdiction or another appropriate authority; or

5. Performs
any other act authorized pursuant to sections 19 to 39, inclusive, of this act.

Sec. 38. If a medical facility:

1. Commits
a violation of any provision of sections 19 to 39, inclusive, of this act or
for any violation for which an administrative sanction pursuant to NRS 449.163
would otherwise be applicable; and

2. Of
its own volition, reports the violation to the administrator,

such a violation must
not be used as the basis for imposing an administrative sanction pursuant to
NRS 449.163.

Sec. 39. The administrator shall adopt such
regulations as the administrator determines to be necessary or advisable to
carry out the provisions of sections 19 to 39, inclusive, of this act.

Secs. 40-43. (Deleted by amendment.)

Sec. 44. Chapter 449 of NRS is
hereby amended by adding thereto the provisions set forth as sections 45 and 46
of this act.

Sec. 45. 1. A medical facility or any agent or employee
thereof shall not retaliate or discriminate unfairly against an employee of the
medical facility or a person acting on behalf of the employee who in good
faith:

(a) Reports
to the board of medical examiners or the state board of osteopathic medicine,
as applicable, information relating to the conduct of a physician which may
constitute grounds for initiating disciplinary action against the physician or
which otherwise raises a reasonable question regarding the competence of the
physician to practice medicine with reasonable skill and safety to patients;

(b) Reports
a sentinel event to the health division pursuant to section 28 of this act; or

(c) Cooperates
or otherwise participates in an investigation or proceeding conducted by the
board of medical examiners, the state board of osteopathic medicine or another
governmental entity relating to conduct described in paragraph (a) or (b).

2. A medical facility
or any agent or employee thereof shall not retaliate or discriminate unfairly
against an employee of the medical facility because the employee has taken an
action described in subsection 1.

3. A medical facility
or any agent or employee thereof shall not prohibit, restrict or attempt to
prohibit or restrict by contract, policy, procedure or any other manner the
right of an employee of the medical facility to take an action described in subsection
1.

(1) Includes,
without limitation, the following action if such action is taken solely because
the employee took an action described in subsection 1:

(I) Frequent
or undesirable changes in the location where the employee works;

(II) Frequent
or undesirable transfers or reassignments;

(III) The
issuance of letters of reprimand, letters of admonition or evaluations of poor
performance;

(IV) A
demotion;

(V) A
reduction in pay;

(VI) The
denial of a promotion;

(VII) A
suspension;

(VIII) A
dismissal;

(IX) A
transfer; or

(X) Frequent
changes in working hours or workdays.

(2) Does not include
action described in subparagraphs (I) to (X), inclusive, of paragraph (1) if
the action is taken in the normal course of employment or as a form of
discipline.

Sec. 46. An employee of a medical facility
who believes that he has been retaliated or discriminated against in violation
of section 45 of this act may file an action in a court of competent
jurisdiction for such relief as may be appropriate under the law.

Sec. 47. Chapter 630 of NRS is
hereby amended by adding thereto the provisions set forth as sections 48 and 49
of this act.

Sec. 48. 1. A physician or any agent or employee thereof
shall not retaliate or discriminate unfairly against an employee of the
physician or a person acting on behalf of the employee who in good faith:

(a) Reports
to the board information relating to the conduct of the physician which may
constitute grounds for initiating disciplinary action

against the physician
or which otherwise raises a reasonable question regarding the competence of the
physician to practice medicine with reasonable skill and safety to patients;

(b) Reports
a sentinel event to the health division pursuant to section 28 of this act; or

(c) Cooperates
or otherwise participates in an investigation or proceeding conducted by the
board or another governmental entity relating to conduct described in paragraph
(a) or (b).

2. A
physician or any agent or employee thereof shall not retaliate or discriminate
unfairly against an employee of the physician because the employee has taken an
action described in subsection 1.

3. A physician or any
agent or employee thereof shall not prohibit, restrict or attempt to prohibit
or restrict by contract, policy, procedure or any other manner the right of an
employee of the physician to take an action described in subsection 1.

4. As
used in this section, retaliate or discriminate:

(a) Includes,
without limitation, the following action if such action is taken solely because
the employee took an action described in subsection 1:

(1) Frequent
or undesirable changes in the location where the employee works;

(2) Frequent
or undesirable transfers or reassignments;

(3) The
issuance of letters of reprimand, letters of admonition or evaluations of poor
performance;

(4) A
demotion;

(5) A
reduction in pay;

(6) The
denial of a promotion;

(7) A
suspension;

(8) A
dismissal;

(9) A
transfer; or

(10) Frequent
changes in working hours or workdays.

(b) Does
not include action described in paragraphs (1) to (10), inclusive, of paragraph
(a) if the action is taken in the normal course of employment or as a form of
discipline.

Sec. 49. An employee of a physician who
believes that he has been retaliated or discriminated against in violation of
section 48 of this act may file an action in a court of competent jurisdiction
for such relief as may be appropriate.

Sec. 50. (Deleted
by amendment.)

Sec. 51. NRS 630.130 is hereby
amended to read as follows:

630.130 1. In addition to the
other powers and duties provided in this chapter, the board shall:

(a) Enforce the provisions of this chapter;

(b) Establish by regulation standards for licensure
under this chapter;

(c) Conduct examinations for licensure and
establish a system of scoring for those examinations;

(d) Investigate the character of each applicant for
a license and issue licenses to those applicants who meet the qualifications
set by this chapter and the board; and

(e) Institute a proceeding in any court to enforce
its orders or the provisions of this chapter.

2. On or before February 15 of each odd-numbered year, the
board shall submit to the governor and to the director of the legislative
counsel

bureau for
transmittal to the next regular session of the legislature a written report
compiling:

(a) Disciplinary
action taken by the board during the previous biennium against physicians for
malpractice or negligence; and

(b) Information
reported to the board during the previous biennium pursuant to NRS 630.3067,
subsections 2 and 3 of NRS 630.307 and NRS 690B.045.

The report must
include only aggregate information for statistical purposes and exclude any
identifying information related to a particular person.

3. The
board may adopt such regulations as are necessary or desirable to enable it to
carry out the provisions of this chapter.

Sec. 52. NRS 630.267 is hereby
amended to read as follows:

630.267 1. Each holder of a
license to practice medicine must, on or before July 1 of each alternate year:

(a) Submit the statement required pursuant to NRS
630.197; [and]

(b) Submit
a list of all actions filed or claims submitted to arbitration or mediation for
malpractice or negligence against him during the previous 2 years; and

(c) Pay
to the secretary-treasurer of the board the applicable fee for biennial
registration. This fee must be collected for the period for which a physician
is licensed.

2. When a holder of a license fails to pay
the fee for biennial registration and submit the statement required pursuant to
NRS 630.197 after they become due, his license to practice medicine in this
state is automatically suspended. The holder may, within 2 years after the date
his license is suspended, upon payment of twice the amount of the current fee
for biennial registration to the secretary-treasurer and submission of the
statement required pursuant to NRS 630.197 and after he is found to be in good
standing and qualified under the provisions of this chapter, be reinstated to
practice.

3. The board shall make such reasonable
attempts as are practicable to notify a licensee:

(a) At least once that his fee for biennial
registration and the statement required pursuant to NRS 630.197 are due; and

(b) That his license is suspended.

A copy of this notice must be sent to the Drug Enforcement
Administration of the United States Department of Justice or its successor
agency.

Sec. 53. NRS 630.3062 is hereby
amended to read as follows:

630.3062 The following acts, among others,
constitute grounds for initiating disciplinary action or denying licensure:

1. Failure to maintain timely, legible,
accurate and complete medical records relating to the diagnosis, treatment and
care of a patient.

2. Altering medical records of a patient.

3. Making or filing a report which the
licensee knows to be false, failing to file a record or report as required by
law or willfully obstructing or inducing another to obstruct such filing.

4. Failure to make the medical records of a
patient available for inspection and copying as provided in NRS 629.061.

5. Failure to [report any claim for
malpractice or negligence filed against the licensee and the subsequent
disposition thereof within 90 days after the:

(b) Disposition
of the claim.]
comply with the requirements of NRS 630.3067.

6. Failure to report any person the licensee
knows, or has reason to know, is in violation of the provisions of this chapter
or the regulations of the board.

Sec. 54. NRS 630.3067 is hereby
amended to read as follows:

630.3067 [Under the provisions of
NRS 690B.045, the]

1. The
insurer of a physician licensed under this chapter and the physician
must report to the board any action
filed or claim submitted
to arbitration or mediation for malpractice or negligence against the physician and
the settlement, award, judgment or other disposition [thereof.] of the action or claim within 30 days
after:

(a) The
action was filed or the claim was submitted to arbitration or mediation; and

(b) The
disposition of the action or claim.

2. The
board shall report any failure to comply with subsection 1 by an insurer
licensed in this state to the division of insurance of the department of
business and industry. If, after a hearing, the division of insurance
determines that any such insurer failed to comply with the requirements of
subsection 1, the division may impose an administrative fine of not more than
$10,000 against the insurer for each such failure to report. If the
administrative fine is not paid when due, the fine must be recovered in a civil
action brought by the attorney general on behalf of the division.

Sec. 55. NRS 630.307 is hereby
amended to read as follows:

630.307 1. Any person, medical
school or medical facility that becomes aware that a person practicing medicine
or respiratory care in this state has, is or is about to become engaged in
conduct which constitutes grounds for initiating disciplinary action shall [forthwith]
file a written complaint with the board[.] within 30 days after becoming aware of
the conduct.

2. Any hospital, clinic or other medical
facility licensed in this state, or medical society, shall [forthwith]
report to the board any change in a physicians privileges to practice medicine
while the physician is under investigation and the outcome of any disciplinary
action taken by that facility or society against the physician concerning the
care of a patient or the competency of the physician[.] within 30 days after the change in
privileges is made or disciplinary action is taken. The board shall report any
failure to comply with this subsection by a hospital, clinic or other medical
facility licensed in this state to the health division of the department of
human resources. If, after a hearing, the health division determines that any
such facility or society failed to comply with the requirements of this
subsection, the division may impose an administrative fine of not more than
$10,000 against the facility or society for each such failure to report. If the
administrative fine is not paid when due, the fine must be recovered in a civil
action brought by the attorney general on behalf of the division.

3. The clerk of every court shall [forthwith]
report to the board any finding, judgment or other determination of the court
that a physician, physician assistant or practitioner of respiratory care:

(c) Has been convicted of a felony or any law
governing controlled substances or dangerous drugs;

(d) Is guilty of abuse or fraud under any state or
federal program providing medical assistance; or

(e) Is liable for damages for malpractice or
negligence[.] ,

within 45 days
after such a finding, judgment or determination is made.

4. On
or before January 15 of each year, the clerk of each court shall submit to the
office of court administrator created pursuant to NRS 1.320 a written report
compiling the information that the clerk reported during the previous year to
the board regarding physicians pursuant to paragraph (e) of subsection 3.

Sec. 56. NRS 630.364 is hereby
amended to read as follows:

630.364 1. Any person or
organization who furnishes information concerning an applicant for a license or
a licensee in good faith and without malicious intent in accordance with the
provisions of this chapter is immune from any civil action for furnishing that
information.

2. The board and any of its members and its
staff, counsel, investigators, experts, committees, panels, hearing officers
and consultants are immune from any civil liability for:

(a) Any decision or action taken in good faith and
without malicious intent in response to information acquired by the board.

(b) Disseminating information concerning an
applicant for a license or a licensee to other boards or agencies of the state,
the attorney general, any hospitals, medical societies, insurers, employers,
patients and their families or any law enforcement agency.

[3. A screening panel or any of its members,
acting pursuant to NRS 41A.003 to 41A.069, inclusive, that initiates or assists
in any proceeding concerning a claim of malpractice against a physician is
immune from any civil action for that initiation or assistance or any
consequential damages, if the panel or members acted without malicious intent.]

Sec. 57. (Deleted by amendment.)

Sec. 58. Chapter 633 of NRS is
hereby amended by adding thereto the provisions set forth as sections 62, 63
and 64 of this act.

Sec. 59. 1. An osteopathic physician or any agent or
employee thereof shall not retaliate or discriminate unfairly against an
employee of the osteopathic physician or a person acting on behalf of the
employee who in good faith:

(a) Reports
to the board information relating to the conduct of the osteopathic physician
which may constitute grounds for initiating disciplinary action against the
osteopathic physician or which otherwise raises a reasonable question regarding
the competence of the osteopathic physician to practice medicine with
reasonable skill and safety to patients;

(b) Reports
a sentinel event to the health division pursuant to section 28 of this act; or

(c) Cooperates
or otherwise participates in an investigation or proceeding conducted by the
board or another governmental entity relating to conduct described in paragraph
(a) or (b).

2. An
osteopathic physician or any agent or employee thereof shall not retaliate or
discriminate unfairly against an employee of the osteopathic physician because
the employee has taken an action described in subsection 1.

3. An
osteopathic physician or any agent or employee thereof shall not prohibit,
restrict or attempt to prohibit or restrict by contract, policy, procedure or
any other manner the right of an employee of the osteopathic physician to take
an action described in subsection 1.

4. As
used in this section, retaliate or discriminate:

(a) Includes,
without limitation, the following action if such action is taken solely because
the employee took an action described in subsection 1:

(1) Frequent
or undesirable changes in the location where the employee works;

(2) Frequent
or undesirable transfers or reassignments;

(3) The
issuance of letters of reprimand, letters of admonition or evaluations of poor
performance;

(4) A
demotion;

(5) A
reduction in pay;

(6) The
denial of a promotion;

(7) A
suspension;

(8) A
dismissal;

(9) A
transfer; or

(10) Frequent
changes in working hours or workdays.

(b) Does
not include action described in paragraphs (1) to (10), inclusive, of paragraph
(a) if the action is taken in the normal course of employment or as a form of
discipline.

Sec. 60. An
employee of an osteopathic physician who believes that he has been retaliated
or discriminated against in violation of section 59 of this act may file an
action in a court of competent jurisdiction for such relief as may be
appropriate under the law.

Sec. 61. (Deleted
by amendment.)

Sec. 62. 1. On or before February 15 of each
odd-numbered year, the board shall submit to the governor and to the director
of the legislative counsel bureau for transmittal to the next regular session
of the legislature a written report compiling:

(a) Disciplinary
action taken by the board during the previous biennium against osteopathic
physicians for malpractice or negligence; and

(b) Information
reported to the board during the previous biennium pursuant to NRS 690B.045,
section 63 of this act and subsections 2 and 3 of section 64 of this act.

2. The
report must include only aggregate information for statistical purposes and
exclude any identifying information related to a particular person.

Sec. 63.1. The insurer of an osteopathic physician
licensed under this chapter and the osteopathic physician must report to the
board any action filed or claim submitted to arbitration or mediation for
malpractice or negligence against the osteopathic physician and the settlement,
award, judgment or other disposition of the action or claim within 30 days
after:

(a) The
action was filed or the claim was submitted to arbitration or mediation; and

(b) The
disposition of the action or claim.

2. The
board shall report any failure to comply with subsection 1 by an insurer licensed
in this state to the division of insurance of the department of business and
industry. If, after a hearing, the division of insurance determines that any
such insurer failed to comply with the requirements of subsection 1, the
division may impose an administrative fine of not more

than $10,000 against
the insurer for each such failure to report. If the administrative fine is not
paid when due, the fine must be recovered in a civil action brought by the
attorney general on behalf of the division.

Sec. 64. 1. Any person, medical school or medical
facility that becomes aware that a person practicing osteopathic medicine in
this state has, is or is about to become engaged in conduct which constitutes
grounds for initiating disciplinary action shall file a written complaint with
the board within 30 days after becoming aware of the conduct.

2. Any
hospital, clinic or other medical facility licensed in this state, or medical
society, shall report to the board any change in an osteopathic physicians
privileges to practice osteopathic medicine while the osteopathic physician is
under investigation and the outcome of any disciplinary action taken by that
facility or society against the osteopathic physician concerning the care of a
patient or the competency of the osteopathic physician within 30 days after the
change in privileges is made or disciplinary action is taken. The board shall
report any failure to comply with this subsection by a hospital, clinic or
other medical facility licensed in this state to the health division of the
department of human resources. If, after a hearing, the health division determines
that any such facility or society failed to comply with the requirements of
this subsection, the division may impose an administrative fine of not more
than $10,000 against the facility or society for each such failure to report.
If the administrative fine is not paid when due, the fine must be recovered in
a civil action brought by the attorney general on behalf of the division.

3. The
clerk of every court shall report to the board any finding, judgment or other
determination of the court that an osteopathic physician or osteopathic
physicians assistant:

(a) Is
mentally ill;

(b) Is
mentally incompetent;

(c) Has
been convicted of a felony or any law governing controlled substances or
dangerous drugs;

(d) Is
guilty of abuse or fraud under any state or federal program providing medical
assistance; or

(e) Is
liable for damages for malpractice or negligence,

within 45 days after
such a finding, judgment or determination is made.

4. On
or before January 15 of each year, the clerk of every court shall submit to the
office of court administrator created pursuant to NRS 1.320 a written report
compiling the information that the clerk reported during the previous year to
the board regarding osteopathic physicians pursuant to paragraph (e) of subsection
3.

Sec. 65. NRS 633.471 is hereby
amended to read as follows:

633.471 1. Except as otherwise
provided in subsection 3 and in NRS 633.491, every holder of a license issued
under this chapter, except a temporary or a special license, may renew his license
on or before January 1 of each calendar year after its issuance by:

(e) Submitting
verified evidence satisfactory to the board that in the year preceding the
application for renewal he has attended courses or programs of continuing
education approved by the board totaling a number of hours established by the
board which must not be less than 35 hours nor more than that set in the
requirements for continuing medical education of the American Osteopathic
Association.

2. The secretary of the board shall notify
each licensee of the requirements for renewal not less than 30 days before the
date of renewal.

3. Members of the Armed Forces of the United
States and the United States Public Health Service are exempt from payment of
the annual license renewal fee during their active duty status.

Sec. 66. NRS 633.511 is hereby
amended to read as follows:

633.511 The grounds for initiating
disciplinary action pursuant to this chapter are:

1. Unprofessional conduct.

2. Conviction of:

(a) A violation of any federal or state law
regulating the possession, distribution or use of any controlled substance or
any dangerous drug as defined in chapter 454 of NRS;

(b) A felony;

(c) A violation of any of the provisions of NRS
616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive; or

(d) Any offense involving moral turpitude.

3. The suspension of the license to practice
osteopathic medicine by any other jurisdiction.

4. Gross or repeated malpractice, which may
be evidenced by claims of malpractice settled against a practitioner.

5. Professional incompetence.

6. Failure
to comply with the requirements of section 63 of this act.

Sec. 67. NRS 690B.045 is hereby
amended to read as follows:

690B.045 Except as more is required in NRS
630.3067[:] and section 63 of this act:

1. Each insurer which issues a policy of
insurance covering the liability of a practitioner licensed pursuant to
chapters 630 to 640, inclusive, of NRS for a breach of his professional duty
toward a patient shall report to the board which licensed the practitioner
within 30 days each settlement or award made or judgment rendered by reason of
a claim, if the settlement, award or judgment is for more than $5,000, giving
the name and address of the claimant and the practitioner and the circumstances
of the case.

2. A practitioner licensed pursuant to
chapters 630 to 640, inclusive, of NRS who does not have insurance covering
liability for a breach of his professional duty toward a patient shall report
to the board which issued his license within 30 days of each settlement or
award made or judgment rendered by reason of a claim, if the settlement, award
or judgment is for more than $5,000, giving his name and address, the name and
address of the claimant and the circumstances of the case.

3. These reports are public records and must
be made available for public inspection within a reasonable time after they are
received by the licensing board.

Sec. 68. NRS 690B.050 is hereby
amended to read as follows:

690B.050 1. Each insurer which
issues a policy of insurance covering the liability of a physician licensed
under chapter 630 of NRS or an

osteopathic
physician licensed under chapter 633 of NRS for a breach of his
professional duty toward a patient shall report to the commissioner within 30
days each settlement or award made or judgment rendered by reason of a claim,
giving the name and address of the claimant and physician and the circumstances
of the case.

2. The commissioner shall report to the
board of medical examiners[,]or the state board of osteopathic
medicine, as applicable, within 30 days after receiving the
report of the insurer, each claim made and each settlement, award or judgment.

Sec. 70. The amendatory provisions
of sections 1 to 6, inclusive, and 11 of this act apply only to a cause of
action that accrues on or after October 1, 2002.

Sec. 71. The amendatory provisions
of sections 7, 8, 12 and 17 apply only to an action filed on or after October
1, 2002.

Sec. 72. 1. Notwithstanding
the repeal of NRS 41A.0043, 41A.005, 41A.008 and 41A.016 to 41A.069, inclusive,
if a claimant has filed a complaint with the division of insurance of the
department of business and industry pursuant to NRS 41A.039 before October 1,
2002, and a determination has not been made by the screening panel as provided
in NRS 41A.003 to 41A.069, inclusive, before October 1, 2002, the claimant may
elect:

(a) To have a determination made by the screening panel
as provided in NRS 41A.003 to 41A.069, inclusive. If the claimant elects to
have a determination made by the screening panel, the provisions of NRS 41A.003
to 41A.069, inclusive, shall be deemed to continue to apply to the claim and to
any subsequent action filed in the district court. If the claimant wishes to
elect to have a determination made by the screening panel, the claimant must,
before December 1, 2002, file written notice of that fact with the division. If
the claimant fails to provide such written notice, the claimant shall be deemed
to have elected to have no further action taken by the screening panel
concerning the complaint.

(b) To have no further action taken by the screening
panel concerning the complaint. If the claimant elects to have no further
action taken by the screening panel concerning the complaint, the division and
the screening panel shall not take any further action with respect to the
complaint, and the claimant may file an action in the district court.

2. Notwithstanding the repeal of NRS 41A.0043,
41A.005, 41A.008 and 41A.016 to 41A.069, inclusive, and the amendment of
paragraph (b) of subsection 2 of NRS 41A.097, if a claimant elects:

(a) To have a determination made by the screening panel,
the tolling of the time limitation provided for review of the complaint by the
screening panel pursuant to NRS 41A.097 shall be deemed to continue to apply
until 30 days after the date on which the screening panel notifies the
claimant, in writing, of its findings.

(b) To have no further action taken by the screening
panel concerning the complaint, the tolling of the time limitation provided for
review of the complaint by the screening panel pursuant to NRS 41A.097 ceases
on December 1, 2002.

(a) Elects to have no further action taken by the
screening panel concerning the complaint;

(b) Files an action in the district court; and

(c) Prevails at the trial of the action,

the claimant is entitled to tax, as costs, the fee paid to the
division pursuant to NRS 41A.039 for filing the complaint.

Sec. 72.5. 1. For
the period beginning on October 1, 2002, and ending on October 1, 2005, the
division shall monitor and maintain records of all:

(a) Premiums
charged for policies of insurance covering the liability of a practitioner
licensed to practice medicine, dentistry or osteopathic medicine pursuant to
chapter 630, 631 or 633 of NRS for a breach of his professional duty toward a
patient; and

(b) Jury
verdicts and settlements of cases and claims relating to the liability of a
practitioner licensed to practice medicine, dentistry or osteopathic medicine
pursuant to chapter 630, 631 or 633 of NRS for a breach of his professional
duty toward a patient, including, without limitation:

(1) The
amount of each jury verdict or settlement;

(2) For
each case or claim, whether any limitation on the amount of any damages
applied; and

(3) For
each case or claim, the effect of any applicable limitation on the amount of
any damages.

2. Not
later than November 1, 2005, the division shall deliver to the commissioner for
review a report that must include, without limitation:

(a) A
summary of the information obtained pursuant to subsection 1; and

(b) Analyses
of any changes or trends in the amounts of or volumes of premiums or jury
verdicts and settlements as evidenced by the information obtained pursuant to
subsection 1.

3. Not
later than December 1, 2005, the commissioner shall submit to the director of
the legislative counsel bureau for transmission to the legislative commission
and the legislature a report that must include, without limitation:

(a) The
findings of the division delivered to the commissioner pursuant to this
section; and

(b) Any
recommendations of the commissioner for legislation based upon the findings of
the division, including, without limitation, any recommendations for annual
adjustments for inflation for any limitations on damages applicable to cases
and claims relating to the liability of a practitioner licensed to practice
medicine, dentistry or osteopathic medicine pursuant to chapter 630, 631 or 633
of NRS for a breach of his professional duty toward a patient.

4. As
used in this section:

(a) Commissioner
has the meaning ascribed to it in NRS 679A.060.

(b) Division has the meaning ascribed to it in NRS
679A.085.

Sec. 73. On or before March 1, 2003,
pursuant to subsection 3 of section 7 of this act, each district court in this
state shall adopt court rules to expedite the resolution of an action involving
medical malpractice or dental malpractice.